Approximately 80% of Americans will have back pain at some time in their lives (1). The historical cause of back pain is not always clear. In some instances the seemingly obvious cause is not necessarily correct. Why did picking up that box cause the pain onset when you have done the same activity hundreds of times before, and maybe heavier boxes? ”Dr. Fischer, I only bent over to dry my foot and I found I could not stand up!” In these circumstances the ‘cause’ was likely cumulative and the activity which by timing seemed associated with the onset was simply the ‘last straw’ that pushed the problem over a threshold, finally causing pain.

Physical findings related to back pain are not always clear, as some patients that show no spinal abnormalities on an x-ray or even MRI yet experience severe pain.

Conservative Treatment Options:

Physical Therapy Your neck and back must have good range of motion. This includes the ability to bend forward bend backward, tip sideways and rotate. Most Americans (adults and now kids) sit for extended periods relatively immobile at work and at home, in cars and in front of computers or televisions. Physical therapy providers recommend ‘movement’ achieved by simple activities as simple as regular walking, expanding into stretching and core strengthening exercises. These exercises should be performed progressively

following an incident of back pain, and then regularly even after the pain and problem subside.

A physical therapist can educate in the performance of correct exercises, including those that fit into most lifestyles. After all, the very best exercises are worthless if they are not going to be performed consistently by an individual.

A physical therapist also has a lengthy list of therapeutic options to use to reduce acute pain and limitations in effort to reach a point where instructed exercises can be performed effectively.

Chiropractic A chiropractor may include manipulation of the spine and other joints in effort to restore normal mobility by stretching the connective tissues between the joints that may have become inflexible and limited due to a sudden injury or simply over time.

Again, appropriate exercises need to be instructed and then regularly performed in order to accentuate the treatment process (speeding it up) and maintain the improvement.

Surgery Only after conservative care (Physical Therapy and Chiropractic) including time, have been exhausted, surgery may be a needed consideration, usually a last resort. Surgery may be necessary where narrowing of the space around the spinal nerves has decreased in size due to disk degeneration, and/or abnormal bone growth due to arthritis, and that is not responding to conservative care.

Though surgery may be needed, the vast majority of back pain can be alleviated without surgery.

What should you do?

Seek professional advice from your regular doctor, a physical therapist or chiropractor. Speak with them about starting with the least invasive treatment options first. This would include physical therapy and chiropractic options. Statistics indicate these initial conservative options will take care of your pain and restore improved function.

The best outcomes will likely occur in treatment plans that get the injured patient moving as soon as possible after the onset of pain.

The best results start with your health care provider, however end with you. You need to be compliant in the instructions given you in the form of future injury prevention and exercises in order to prevent return of the problem.

Back pain may be a sign of poor body fitness which may have been progressing for years (they do fly by). Patients that are strong and flexible have a much lesser occurrence of back pain. Lose this strength and flexibility over time and back pain will become much more likely. Overlook one of those areas, however, and your back will let you know. And while the emotional link to back pain is controversial, there's no question that stress can play a part in muscle tension, especially in the upper back, lower back and hips, leading to trouble.